The use of seat belt cushion accessories among drivers aged 75 years and older

![CDATA[Chest injuries are the most common crash injuries among elderly occupants. While seatbelts are highly successful in reducing risk of death and injury in crashes, the seatbelt is the most common source of chest injuries in older occupants. Seatbelt effectiveness may be affected by the use of add-on accessories used to improve occupant comfort. This paper examines the use of seatbelt and seat cushion accessories among drivers aged 75 years and older. Self-reported seatbelt wearing patterns were collected using a survey and accessory use was assessed from observations of older drivers in their own vehicles. Height and weight measurements of drivers were also taken. Logistic regression was used to examine associations between occupant anthropometry, reported comfort and accessory use. Data from 367 participants was collected. Self-reported seatbelt use was high (99%), however, 23% were observed using a belt or cushion accessory. This included 9% using seatbelt comfort pads, and 17% using accessory cushions such as a seat base cushion, seat back cushion, back support or head-rest cushion. Seatbelt pads were more likely to be used by shorter drivers (OR1.07 95%CI 1.02-1.13), and cushion accessories were more likely to be used by drivers who reported belt comfort problems (OR2.5 95%CI 1.1-5.6). It is possible that many of the observed accessories would negatively impact crash protection by inducing slack into the system and the impact on crash protection requires further investigation. In the interim, other solutions, such as the use of adjustable D Rings should be encouraged.]]